I've got two datasets - 1) a set of buildings in LA and 2) fiber optic cable maps from a company called Zayo which covers the whole of the US. I'd like to find the buildings within a certain distance to the fiber. The SRID is 4326 and it's stored as a geometry, not geography (as far as I can tell).

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So the very long multi-line-segment from zayo_fiber was causing the efficiency issue. I ended up using ST_Dump to break it up into 55,000 rows, which I then indexed. The query now runs in less than a second.